Effect of One Night of Nocturnal Oxygen Supplementation on Highland Patients With OSA : A Randomized, Crossover Trial
Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved..
BACKGROUND: The treatment of OSA in highland residents is not established.
RESEARCH QUESTIONS: Does nocturnal oxygen supplementation (NOS) improve sleep-related breathing disturbances, nocturnal oxygenation, and cognitive performance in patients with OSA living at 3,200 m?.
STUDY DESIGN AND METHODS: Forty patients with OSA permanently living in Shangri-La, China at 3,200 m (median age [interquartile range], 47.0 [44.0-53.0] years; oxygen desaturation index, 38.4/h [34.2/h-52.3/h]), were randomly assigned to receive nasal NOS and sham oxygen (ambient air), for one night each, at 2 L/min, in a crossover design, separated by a washout period of 2 weeks. During treatment nights polysomnography was performed, and further outcomes were evaluated the next morning. The primary outcome was the difference in apnea-hypopnea index (AHI) between nights with NOS and nights with sham oxygen.
RESULTS: During nights with sham oxygen, the median (interquartile range) total AHI was 43.4/h (31.1/h-67.5/h), the obstructive AHI was 41.9/h (28.5/h-66.8/h), and the central AHI was 0.6/h (0.1/h-1.3/h); blood oxygenation as determined by pulse oximetry (Spo2) was 87.0% (84.5%-89.0%). In intention-to-treat analysis, NOS decreased the total AHI by a median of 17.9/h (95% CI, 8.0/h-27.1/h; P < .001), through a reduction in obstructive AHI by 16.0/h (95% CI, 6.8/h-26.0/h; P < .001) and central AHI by 0.4/h (95% CI, 0.1/h-0.9/h; P < .001). NOS also increased Spo2 by 7.0% (95% CI, 6.0%-8.0%; P < .001). Heart rate during sleep and pulse rate in the morning after NOS were significantly reduced, but subjective sleep quality and cognitive performance showed no changes.
INTERPRETATION: In highland residents with OSA, NOS significantly improved sleep-related breathing disturbances and nocturnal oxygenation. NOS also reduced heart rate during sleep and morning pulse rate. If these beneficial effects are confirmed in longer term studies, NOS may be a treatment option for highland patients with OSA who cannot be treated by CPAP.
TRIAL REGISTRY: Chinese Clinical Trial Registry; No.: ChiCTR1800017715; URL: http://www.chictr.org.cn/showproj.aspx?proj=29768.
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:160 |
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| Enthalten in: |
Chest - 160(2021), 2 vom: 05. Aug., Seite 690-700 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tan, Lu [VerfasserIn] |
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Altitude |
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Date Completed 03.01.2022 Date Revised 03.01.2022 published: Print-Electronic CommentIn: Chest. 2021 Aug;160(2):411-412. - PMID 34366029 Citation Status MEDLINE |
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| doi: |
10.1016/j.chest.2021.02.046 |
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| PPN (Katalog-ID): |
NLM322247845 |
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| 100 | 1 | |a Tan, Lu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Effect of One Night of Nocturnal Oxygen Supplementation on Highland Patients With OSA |b A Randomized, Crossover Trial |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 03.01.2022 | ||
| 500 | |a Date Revised 03.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Chest. 2021 Aug;160(2):411-412. - PMID 34366029 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The treatment of OSA in highland residents is not established | ||
| 520 | |a RESEARCH QUESTIONS: Does nocturnal oxygen supplementation (NOS) improve sleep-related breathing disturbances, nocturnal oxygenation, and cognitive performance in patients with OSA living at 3,200 m? | ||
| 520 | |a STUDY DESIGN AND METHODS: Forty patients with OSA permanently living in Shangri-La, China at 3,200 m (median age [interquartile range], 47.0 [44.0-53.0] years; oxygen desaturation index, 38.4/h [34.2/h-52.3/h]), were randomly assigned to receive nasal NOS and sham oxygen (ambient air), for one night each, at 2 L/min, in a crossover design, separated by a washout period of 2 weeks. During treatment nights polysomnography was performed, and further outcomes were evaluated the next morning. The primary outcome was the difference in apnea-hypopnea index (AHI) between nights with NOS and nights with sham oxygen | ||
| 520 | |a RESULTS: During nights with sham oxygen, the median (interquartile range) total AHI was 43.4/h (31.1/h-67.5/h), the obstructive AHI was 41.9/h (28.5/h-66.8/h), and the central AHI was 0.6/h (0.1/h-1.3/h); blood oxygenation as determined by pulse oximetry (Spo2) was 87.0% (84.5%-89.0%). In intention-to-treat analysis, NOS decreased the total AHI by a median of 17.9/h (95% CI, 8.0/h-27.1/h; P < .001), through a reduction in obstructive AHI by 16.0/h (95% CI, 6.8/h-26.0/h; P < .001) and central AHI by 0.4/h (95% CI, 0.1/h-0.9/h; P < .001). NOS also increased Spo2 by 7.0% (95% CI, 6.0%-8.0%; P < .001). Heart rate during sleep and pulse rate in the morning after NOS were significantly reduced, but subjective sleep quality and cognitive performance showed no changes | ||
| 520 | |a INTERPRETATION: In highland residents with OSA, NOS significantly improved sleep-related breathing disturbances and nocturnal oxygenation. NOS also reduced heart rate during sleep and morning pulse rate. If these beneficial effects are confirmed in longer term studies, NOS may be a treatment option for highland patients with OSA who cannot be treated by CPAP | ||
| 520 | |a TRIAL REGISTRY: Chinese Clinical Trial Registry; No.: ChiCTR1800017715; URL: http://www.chictr.org.cn/showproj.aspx?proj=29768 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a altitude | |
| 650 | 4 | |a hypoxia | |
| 650 | 4 | |a oxygen therapy | |
| 650 | 4 | |a sleep apnea | |
| 700 | 1 | |a Li, Taomei |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Yanyan |e verfasserin |4 aut | |
| 700 | 1 | |a He, Deping |e verfasserin |4 aut | |
| 700 | 1 | |a Luo, Lian |e verfasserin |4 aut | |
| 700 | 1 | |a Lei, Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Ren, Rong |e verfasserin |4 aut | |
| 700 | 1 | |a He, Jiaming |e verfasserin |4 aut | |
| 700 | 1 | |a Bloch, Konrad E |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Xiangdong |e verfasserin |4 aut | |
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